Revision 19-5; Effective September 27, 2019

 

The 84th Session of the Texas Legislature provided local intellectual and disability development authorities (LIDDAs) with funds to support persons with intellectual and developmental disabilities (IDD) with significant behavioral and psychiatric challenges. These persons often exhibit significant needs requiring additional support beyond the array of services typically provided within community programs. The funds expanded resources to address crisis situations with persons who have IDD.

 

19100 Definitions

Revision 19-5; Effective September 27, 2019

 

In this section, the terms below have the following meanings.

Crisis – A situation in which:

  • the person presents an immediate danger to self or others; or
  • the person’s mental or physical health is at risk of serious deterioration; or
  • a person believes he or she presents an immediate danger to self or others; or
  • that his or her mental or physical health is at risk of serious deterioration.

Crisis respite – Means short-term (up to 14 calendar days) respite for intellectual and developmental disabilities (IDD) as follows:

  • Out-of-home crisis respite provides therapeutic support in a safe environment with staff on-site providing 24-hour supervision to a person who is demonstrating a crisis that cannot be stabilized in a less intensive setting. Out-of-home crisis respite is provided in a setting for which the state provides oversight (for example, an intermediate care facility (ICF), a Home and Community-based Services (HCS) group home, a Department of State Health Services (DSHS)-authorized crisis respite facility or crisis residential facility); and
  • In-home crisis respite provides therapeutic support to a person who is demonstrating a crisis in the person’s home when it is deemed clinically appropriate for the person to remain in his or her natural environment and it is anticipated the crisis can be stabilized within a 72-hour period.

MCOT – Mobile Crisis Outreach Team funded by DSHS pursuant to its contracts with local mental health authorities, specifically, Information Item V, available on the Texas Department of State Health Services website.

Therapeutic support – A flexible array of services, including behavioral support provided for persons with IDD who require varying therapeutic and habilitative levels of intervention to holistically address the stressors that result in challenging behaviors. Support may include training in:

  • Activities to strengthen appropriate developmental functioning in areas of socialization, self-advocacy and rights;
  • Developing coping skills; and
  • Reducing or avoiding stressors to prevent crisis events.

Transition Support Team – (formerly referred to as the "Medical, Behavioral, and Psychiatric Support Team") means a team of professionals, regionally constituted, to provide educational activities, technical assistance, and de-identified case-specific peer review support to local intellectual and disability development authorities (LIDDAs) and IDD providers within a region.

 

19200 Duties of a Crisis Intervention Specialist

Revision 19-5; Effective September 27, 2019

 

The local intellectual and developmental disability authority (LIDDA) must ensure a crisis intervention specialist provides information about intellectual and developmental disability (IDD) programs and services to:

  • person’s with IDD and their families; and
  • IDD providers in the local service area.

The LIDDA must ensure the specialist collaborates with appropriate LIDDA staff and Transition Support Team members to identify persons with IDD in the LIDDA’s local service area who are at risk of requiring crisis services, such as persons who exhibit repeated and severe behavior disturbances that jeopardize the person’s safety or current living arrangement.

The LIDDA must ensure that for a person identified in the above paragraph:

  • collaborates with the service coordinator, other members of the service planning team, and paid provider, if any, to identify:
    • prevention strategies to avoid potential crisis events and to promote the person’s coping skills; and
    • training and support needs that provide the greatest chance of success of living in the community, such as scheduled respite services or planned crisis respite to avoid a potential crisis event; and
  • supports the service coordinator’s provision of ongoing follow-up and monitoring activities, including assisting the service coordinator, other members of the service planning team and paid provider, if any, in addressing concerns and issues identified during follow-up and monitoring visits, such as involvement with law enforcement or emergency room visits.

The LIDDA must ensure a crisis intervention specialist (CIS) provides education about the manner in which to engage persons with IDD and their unique needs to:

  • members of a Mobile Crisis Outreach Team (MCOT) to increase the competency of the members;
  • law enforcement; and
  • others as appropriate.

The LIDDA must ensure a CIS:

  • is available to provide consultation to an MCOT as needed or as clinically indicated regarding a crisis event involving a person with IDD;
  • collaborates with an MCOT to develop criteria for referring a person with IDD in crisis to crisis respite;
  • for a person referred to crisis respite, develops a crisis respite service plan describing the therapeutic support needed by the person;
  • collaborates with the service coordinator, other members of the service planning team, paid provider, if any, and natural supports regarding crisis follow-up and relapse prevention activities, including;
    • assisting with a person’s transition from a crisis respite back to his or her home or other appropriate setting; and
    • addressing concerns and issues identified during follow-up and monitoring visits, such as involvement with the law enforcement or emergency room visits; and
  • documents all activities, collaboration and consultation provided in accordance with this section.

 

19300 Communicating to Stakeholders

Revision 19-5; Effective September 27, 2019

 

The local intellectual and developmental disability authority (LIDDA) is responsible for communicating to stakeholders, including intellectual and developmental disability providers, advocacy organizations, law enforcement and schools about the creation of the crisis intervention specialist (CIS) position and the general duties of the position.

 

19400 Required Training for a CIS and Staff

Revision 19-5; Effective September 27, 2019

 

The local intellectual and developmental disability authority (LIDDA) must ensure a crisis intervention specialist (CIS) completes the training modules available on the Mental Health Wellness for Individuals with Intellectual and Developmental Disabilities website within 30 calendar days after being assigned as a CIS. The LIDDA must ensure the CIS completes additional training modules within 45 days of the posting of new modules on this site.